Expert: Jene Aviram - 1/29/2010

Question
Concerned about my identical twin boys who will be 15 months old in a few days, and I can't stop worrying about autism, particularly regressive autism.  They most likely have speech delay, but so far appear to be doing well socially. I don’t know if they are meeting physical milestones- they are starting to walk (around a corner, etc. before losing balance) but still crawl most of the time, I don’t know if this is within the normal range, either.

I have a few minor concerns, but one of the main ones I can't stop worrying is the recent study that showed over 50% of autistic children (early onset and regressive) had head sizes at or under the 25th percentile and head growth spurts between 9-14 months.  I think this is a related article. http://pediatrics.about.com/b/2003/07/16/head-size-and-autism.htm

Our twins were born early (35 weeks and 5 days) and their head circumferences were both under the 5th percentile.  At their 12 month check-up, one was around 80% and the other around 90%!

I am also concerned about their possible speech delay, and don’t know for sure if they are using mama and dada appropriately (though I think so).

I don’t know if there might be any correlation between their likely speech delay or otherwise, but I am a poster child for ADD, their father was diagnosed with ADHD as a child, and had severe dyslexia.

Answer
Hi Josephine,

Take that study out your mind.  That article said they tested 48 kids.  That's it!  If this was a reliable way to test for autism, then pediatricians worldwide would be measuring head circumferences and diagnosing autism without any diagnostic evaluations.  Your twins were born early.  They are growing well and thank goodness for that!  There are so many speculations about testing for autism in babies.  I hear from so many concerned parents and then a few months later they are relieved when everything turns out OK.

You really didn't mention any concerning behaviors but it does sound as though their speech might be delayed.  At 15 months your twins should have a few words and should be discriminating between mama and dada.  If I were in your shoes I would talk to your pediatrician and ask who you should contact to get an evaluation from Early Intervention.  This service is free as your kids are still very young and if they require any services, they'll be given to you as well.  The waiting list is often long for an evaluation, so ask your pediatrician as soon as possible.

It's totally natural that you feel more concerned because of having a disability in the family.  I'd like you to read the following article called "How do you know if your child has autism?" as well as do the M-CHAT test.  Your kids are still a bit young.  These are really designed for kids who are 18 months and up.  But keep it on hand for a later date.  It might send your mind at ease which is a wonderful thing.
The article is at http://www.nlconcepts.com/autism-howdoyouknow.htm
The M-CHAT is at http://www.nlconcepts.com/autism-mchat.htm

I hope this has been of some help.
I wish you great luck and success.

Jene Aviram
http://www.nlconcepts.com